A patient is very short of breath. Which finding should cause the nurse to be concerned that the shortness of breath might be due to heart failure?

An echocardiogram that reflected increased right ventricular wall thickening

A left ventricular ejection fraction (VEF) of 50%

A B-type natriuretic peptide (BNP) of 300 pg/mL

A serum sodium of 135

Answer and Explanation

The Correct Answer is B

A. An increase in O2 saturation to greater than 90%: An increase in oxygen saturation is typically a positive sign and does not indicate worsening heart failure.

B. The onset of atrial fibrillation: The development of atrial fibrillation in a patient with heart failure is a sign of worsening heart failure, as it indicates increased atrial pressure and the potential for further hemodynamic compromise.

C. Louder S1 and S2 heart sounds: Louder heart sounds do not specifically indicate worsening heart failure. They may vary based on other factors such as body habitus or the position of the patient.

D. A decrease in heart rate to 66 bpm: A heart rate of 66 bpm is within the normal range and does not suggest worsening heart failure.

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Correct Answer is C

Explanation

A. "A complex measurement that should only be discussed with your health care provider": This response is dismissive and does not provide the patient with valuable information or education.

B. "A measurement that should always be 120/80 unless complications are present": While 120/80 mmHg is a common target, blood pressure varies based on individual health and other factors.

C. "A measurement that takes into consideration the amount of blood that your heart is pumping and the size of the vessel diameter the heart must pump against": This response accurately explains that blood pressure is the force of blood against the walls of the arteries and is influenced by cardiac output and vascular resistance.

D. "The amount of pressure exerted on your veins by the blood": Blood pressure refers to the pressure within the arteries, not veins.

A. Monitoring of results of liver function testing B. Assessment for signs and symptoms of jaundice C. Measurement of abdominal girth and body weight D. Assessment for variceal bleeding

Correct Answer is C

Explanation

A. Monitoring of results of liver function testing: While important, monitoring liver function tests is a routine assessment rather than a prioritized one compared to assessing for complications like ascites.

B. Assessment for signs and symptoms of jaundice: Jaundice is a common finding in cirrhosis but does not necessarily indicate an acute complication.

C. Measurement of abdominal girth and body weight: In advanced cirrhosis, monitoring for ascites and fluid retention is critical as these indicate worsening disease and potential complications.

D. Assessment for variceal bleeding: Incorrect. While important, the priority in routine assessment is monitoring for ascites and fluid overload, which can be managed more readily.

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A patient is very short of breath. Which finding should cause the nurse to be concerned that the shortness of breath might be due to heart failure?

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Naxlex Comprehensive Predictor Exams

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Explanation

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